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General NPI Number Information
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NPI Number | 1063850659
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Entity Type | Individual
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Provider Name | JENNA BREANNE SASSIE M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/05/2013
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Last Update Date | 12/07/2022
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Provider Practice Location Address
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Address Line | 5373 W ALABAMA ST STE 206
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City | HOUSTON
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State | TX
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Zip | 77056-5923
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Country | US
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Telephone | 713-975-8353
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Fax | 713-975-1143
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Provider Business Mailing Address
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Address Line | 1315 ST JOSEPH PKWY STE 1818
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City | HOUSTON
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State | TX
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Zip | 77002-8238
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Country | US
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Telephone | 713-654-8128
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Fax | 713-654-7426
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | BP10046807
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | R2730
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License Number State | TX
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